多柔比星脂质体在Ⅱ、Ⅲ期乳腺癌新辅助化疗中的临床疗效

Clinical Effect of Doxorubicin Liposomes in Neoadjuvant Chemotherapy for StageⅡandⅢBreast Cancer

【目的】探讨多柔比星脂质体在Ⅱ、Ⅲ期乳腺癌新辅助化疗中的临床疗效。【方法】本院收治的82例拟行新辅助化疗的Ⅱ期、Ⅲ期乳腺癌患者随机分为观察组和对照组,每组41例。对照组采用多柔比星(40 mg/m^(2))联合环磷酰胺(600mg/m^(2))序贯多西他赛(85mg/m^(2))新辅助化疗,观察组采用多柔比星脂质体(40 mg/m^(2))联合环磷酰胺(600mg/m^(2))序贯多西他赛(85mg/m^(2))化疗,均治疗8个周期。对比两组临床疗效、手术治疗情况及术后病理情况,统计化疗期间不良反应发生情况,随访两组生存情况。【结果】两组治疗有效率、疾病控制率、手术治疗率、病理完全缓解率、腋窝淋巴结转阴率比较差异均无统计学意义(P>0.05);化疗期间,观察组Ⅰ~Ⅱ级心肌损害、Ⅰ~Ⅱ级手足综合征发生率低于对照组(P<0.05),两组不良反应发生率比较差异均无统计学意义(P>0.05)。Kaplan-Meier生存分析显示,观察组3年无进展生存曲线优于对照组(P<0.05),两组总生存曲线比较差异无统计学意义(P>0.05)。【结论】Ⅱ、Ⅲ期乳腺癌患者应用多柔比星脂质体联合环磷酰胺序贯多西他赛新辅助化疗近期疗效确切,可降低Ⅰ~Ⅱ级心肌损害及Ⅰ~Ⅱ级手足综合征发生率,延长无进展生存期,但对总生存期无明显影响。

【Objective】To investigate the clinical effect of doxorubicin liposomes in neoadjuvant chemotherapy for stageⅡandⅢbreast cancer.【Methods】Eighty two patients with stageⅡ-Ⅲbreast cancer who were admitted to our hospital were recruited in the study.Patients were divided into the observation group and the control group by random method,with 41 cases in each group.The control group received doxorubicin 40 mg/m^(2)combined with cyclophosphamide 600 mg/m^(2),sequentially followed by docetaxel 85 mg/m^(2)neoadjuvant chemotherapy,while the observation group received doxorubicin liposome 40 mg/m^(2)combined with cyclophosphamide 600 mg/m^(2)followed by docetaxel 85 mg/m^(2)chemotherapy for 8 cycles of treatment.The clinical efficacy,surgical treatment and postoperative pathology of the two groups were compared between the two groups.and the incidence of adverse reactions during neoadjuvant chemotherapy were counted.Follow up the survival of the two groups were followed up and performed Kaplan-Meier survival analysis.【Results】There were no statistically significant differences between the two groups in treatment efficiency,clinical control rate,disease control rate,pathological complete remission rate,and axillary lymph node conversion rate(P>0.05).During the neoadjuvant chemotherapy between the two groups,the incidence of gradeⅠ~Ⅱmyocardial damage and gradeⅠ~Ⅱhand-foot syndrome in the observation group was lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of other side effects between the two groups(P>0.05).Kaplan-Meier survival analysis showed that the 3-year progression-free survival curve of the observation group was better than that of the control group(P<0.05),however,there was no statistically significant difference in the overall survival curve between the two groups(P>0.05).【Conclusion】The short-term effect of doxorubicin liposome combined with cyclophosphamide sequentially followed by docetaxel neoadjuvant chemotherapy for patients with stageⅡandⅢbreast cancer is definitely effective,which can reduce the incidence of myocardial damage and hand-foot syndrome,and prolong progression-free survival,but has no significant effect on overall survival.